The two goals of the national framework for prevention, Healthy People 2010, are to increase quality and years of healthy life and to eliminate health disparities (U.S. Department of Health and Human Services 2000). Healthy People 2010 thereby concentrates on 28 focus areas, including immunization and infectious diseases. Influenza vaccination constitutes the primary policy tool for reducing influenza virus circulation as well as preventing infections and their associated complications, which can be especially serious for older people. Despite its document efficacy and cost-effectiveness, influenza vaccine use among older people has leveled off well below full uptake over the last decade, especially among ethnic minorities. Efforts to increase influenza vaccination among adults focus primarily on improving administrative procedures to facilitate vaccination in office-based settings, where most vaccines are given. Patient-provider encounters offer important opportunities for information exchange regarding the benefits and safety of influenza vaccinations, and physician recommendations are strongly associated with vaccine uptake. Yet, while office- based strategies have been shown to be effective in increasing influenza vaccination rates, there is only limited evidence regarding their impact on ethnic disparities in vaccine uptake. To increase knowledge in this area, we will analyze recently collected survey data on influenza vaccine uptake during the 2007-08 and 2008-09 influenza vaccination seasons, influenza-related beliefs and attitudes, and interactions with health care providers among a nationally representative sample of U.S. adults age 18 and older. Particular attention will be given to ethnic disparities in vaccination uptake and the role of differential interactions with health care providers for explaining this gap. Specifically, will use detailed data on influenza vaccine uptake and vaccine-related provider interactions together with statistical decomposition methods to unravel the effects of differential exposures to provider interactions across ethnic groups, differential impacts of these provider interactions on influenza vaccine uptake, and differences in reluctance to get vaccinated that are unrelated to provider interactions. Our results will shed light on the roles of differential access to care and provider-based counseling, potential differences in the effectiveness of such patient-provider communications, and possible ethnic differences in attitudes toward influenza immunizations. Our results will thus identify critical shortcomings in different aspects of current patient-provider interactions regarding influenza and influenza immunizations, and help inform the design and implementation of culturally appropriate interventions aimed at improving those. PUBLIC HEALTH RELEVANCE: The goal of this project is to analyze ethnic differences in health care providers interactions regarding influenza vaccinations and their role for persistent disparities influenza vaccine use. To accomplish this objective, we will use detailed data on influenza vaccine uptake and vaccine-related provider interactions together with statistical decomposition methods to highlight ethnic heterogeneity in different aspects of health care provider interactions, such as their frequency and impact, and these impact disparities in vaccination uptake. Our results will thus identify critical shortcomings in different aspects of current patient-provider interactions regarding influenza and influenza immunizations, and help inform the design and implementation of culturally appropriate interventions aimed at improving those.